title: Efficacy of endoscopic mucosal resection using a dual-channel endoscope compared with endoscopic submucosal dissection in the treatment of rectal neuroendocrine tumors.
abstract: BACKGROUND
  Conventional endoscopic mucosal resection (EMR) for removing rectal neuroendocrine tumors (NETs) has a high risk of incomplete removal because of submucosal tumor involvement. EMR using a dual-channel endoscope (EMR-D) may be a safe and effective method for resection of polyps in the gastrointestinal tract. The efficacy of EMR-D in the treatment of rectal NET has not been evaluated thoroughly.
  
  
  METHODS
  From January 2005 to September 2011, a total of 70 consecutive patients who received EMR-D or endoscopic submucosal dissection (ESD) to treat a rectal NET <16 mm in diameter were included to compare EMR-D with ESD for the treatment of rectal NETs.
  
  
  RESULTS
  The EMR-D group contained 44 patients and the ESD group contained 26 patients. The endoscopic complete resection rate did not differ significantly between the EMR-D and ESD groups (100 % for each). The histological complete resection rate also did not differ significantly between groups (86.3 vs. 88.4 %). The procedure time was shorter for the EMR-D group than for the ESD group (9.75 ± 7.11 vs. 22.38 ± 7.56 min, P < 0.001). Minor bleeding occurred in 1 EMR-D patient and in 3 ESD patients (2.3 vs. 7.6 %). There was no perforation after EMR-D or ESD.
  
  
  CONCLUSIONS
  Compared with ESD, EMR-D is technically simple, minimally invasive, and safe for treating small rectal NETs contained within the submucosa. EMR-D can be considered an effective and safe resection method for rectal NETs <16 mm in diameter without metastasis.
authors.affiliation: Gastrointestinal Center, Department of Internal Medicine, Medical College, Seoul St. Mary's Hospital, Catholic University of Korea, 222 Banpo-Daero, Seocho-Gu, Seoul, 137-040, Korea, luke36@gmail.com.
authors.forename: Wook-Hyun
authors.initials: WH
authors.lastname: Lee
authors.forename: Sang-Woo
authors.initials: SW
authors.lastname: Kim
authors.forename: Chul-Hyun
authors.initials: CH
authors.lastname: Lim
authors.forename: Jin-Soo
authors.initials: JS
authors.lastname: Kim
authors.forename: Yu-Kyung
authors.initials: YK
authors.lastname: Cho
authors.forename: In-Seok
authors.initials: IS
authors.lastname: Lee
authors.forename: Myung-Gyu
authors.initials: MG
authors.lastname: Choi
authors.forename: Kyu-Yong
authors.initials: KY
authors.lastname: Choi
mesh_terms: D004210:Dissection / Q000009:adverse effects / Q000379:methods*; D019723:Endoscopes; D016099:Endoscopy, Gastrointestinal / Q000295:instrumentation* / Q000379:methods*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000473:pathology / Q000601:surgery*; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome